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Does race impact survival for patients with anal squamous cell carcinoma?
Author(s) -
Fields Adam C.,
Welten Vanessa M.,
Lu Pamela,
Goldberg Joel E.,
Irani Jennifer,
Bleday Ronald,
Melnitchouk Nelya
Publication year - 2019
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25712
Subject(s) - medicine , stage (stratigraphy) , anal cancer , proportional hazards model , negroid , gastroenterology , cancer , survival analysis , disease , epidemiology , paleontology , biology
Background/Objectives Racial disparities are known to impact cancer outcomes. The aim of this study was to assess current racial disparities in outcomes of anal squamous cell carcinoma (SCC). Methods The National Cancer Database was used to identify patients with anal SCC. The primary outcome was 5‐year overall survival. Results There were 32 255 (88.1%) White patients and 4342 (11.9%) Black patients identified with anal SCC. Compared to White patients, Black patients were more likely to be younger, have lower median income, and be insured with Medicaid (all P < .001). The 5‐year overall survival of Black and White patients for stage I disease was 71.2% and 80.6% ( P < .001), for stage II disease, was 64.6% and 69.3% ( P = .001), for stage III disease was 50.9% and 58.1% ( P < .001), and for stage IV disease was 22.1% and 21.9% ( P = .20). In a cox regression analysis, Black race was associated with significantly worse survival in stage I (HR: 1.37, 95% CI: 1.07‐1.76, P = .01), stage II (HR: 1.30, 95% CI: 1.14‐1.48, P < .001), and stage III disease (HR: 1.31, 95% CI: 1.16–1.47, P < .001) but not for stage IV disease (HR: 1.09, 95% CI: 0.89‐1.35, P = .41). Conclusions Black race is correlated with worse survival in patients diagnosed with anal SCC. This disparity in survival is likely multifactorial and requires further study.